- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,191.50 / $20,500.20 / $29,026.00
| Facility | | $11,191.50 | $20,500.20 | $29,026.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,945.09 / $18,945.09 / $18,945.09
| Facility | | $18,945.09 | $18,945.09 | $18,945.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,635.80 / $18,440.98 / $32,809.43
| Facility | | $11,635.80 | $18,440.98 | $32,809.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $17,977.31 / $38,797.21
| Facility | | $5,264.00 | $17,977.31 | $38,797.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,464.66 / $34,477.23
| Facility | | $3,308.00 | $16,464.66 | $34,477.23 |